Thursday, February 02, 2006

Failing Grades: The American College of Emergency Physicians has issued a report card on the state of emergency care in the nation. It's not so good:

The number of people coming to emergency departments continues to increase, with nearly 114 million patient visits in 2003, the highest number ever, according to the Centers for Disease Control and Prevention (CDC). At the same time, the overall capacity of the nation?s emergency systems has decreased, with hundreds of emergency departments closing in the past 10 years. The number of emergency departments has decreased by 14 percent since 1993, according to the CDC, and hospitals are operating far fewer inpatient beds than they did a decade ago. During the 1990s, hospitals lost 103,000 staffed inpatient medical-surgical beds and 7,800 intensive care unit beds nationwide.

Most of the problem is budgetary. Due to declining reimbursement, hospitals have had to cut back on staffing and thus on beds. The fewer beds, the more likely a back up is to occur in the emergency room as people wait to be admitted to the hospital. And part of the problem is malpractice fears. Many doctors in high-risk specialties refuse to participate in emergency care - the riskiest care there is. If a hospital can't get any neurosurgeons or trauma surgeons to be on call, then they can't have trauma beds. Even worse, some hospitals have had to close their emegency rooms completely because they couldn't get doctors to staff them. Remember that the next time you hear someone say the medical malpractice crisis is "just made up" and a "scare tactic."